Wednesday, June 6, 2012

"But I just started working here!"

Me, to a nurse, 3AM: "Hi, I just need you to put a Foley catheter into Patient Smith, when you get a chance."

Nurse: "I'm sorry, I just started working here."

Me: "Okay.... I'm [name]. Nice to meet you."

Nurse: "No, I meant I don't feel comfortable putting in a Foley. Sorry."

Me: "I don't feel comfortable putting in a Foley either, on zero hours of sleep, and having put in, uh, two Foleys myself in the past three years, since nurses are supposed to be able to do it. And I have six other patients to see. Is there another nurse you can ask?"

Nurse: "I don't feel comfortable asking anyone else, since I just started working here."

Me: "Okay, well, I need someone to do this. And you should learn how to do it, since you're going to have to do it."

Nurse: "I'm not sure what I'm supposed to know how to do. I just started working here."

Me: "Please stop saying that!"

Nurse: "Can't you call the GI fellow?"

Me: "You mean the GU fellow?"

Nurse: "I don't know. Where does a catheter go?"

Me: "Oh, wow. No, I don't feel comfortable calling the GU fellow at home at 3AM about a Foley catheter. Is there another nurse on with you?"

Nurse: "She told me not to bother her."

Me: "Okay, how about you bother her, and one of you puts in the Foley catheter, okay?"

Nurse: "I don't think I can do that. I just started working here."

Me: "Okay, I'm going to call my intern and the two of us are going to put in the Foley catheter, and then I'm going to tell your supervisor that you need to be trained on how to put in Foley catheters, and then I'm going to try and get some sleep and forget this conversation."

Nurse: "That sounds good, except for the part about talking to my supervisor. Do you have to? Since I just started working here and everything."

Me: "Please go somewhere else."

Nurse: "I'm supposed to stay at the nurse's station."

Me: "Can you at least get me a Foley catheter so I can put it in Patient Smith?"

I'm sure they still teach that in nursing school. Now I understand why doctors treat nurses as though we don't have a brain cell between us until we prove otherwise. Sad.It's very frustrating for the nurses who are competent.Did she just start working there?

Either your hospital does an amazingly awful job at orienting new nurses (we had to get "checked off" on all skills, including foleys and NGs) or this nurse needs a swift kick in the pants. Or both. If she's not even willing to ask her peers for help learning a new skill, how on earth will she ever get better than she currently is? What if you had just entered an order, "Insert foley" - what would she have done then? Ignore it and hope it went away?

The best advice I ever got in nursing school (after being chewed out by a surgeon on my very first day of clinicals) was that you never tell a doc "I don't know." It's too passive, and is seen as a cop out. Instead, you say, "I don't know, but let me find out for you," and then follow up by finding the information one way or another. Not knowing something is not a character flaw; choosing not to learn anything new is.

I'm sure she would be welcome at my company when she gets booted out of the hospital, (hopefully soon because I don't want her anywhere near me or anyone I know that I don't actively HATE)where the only qualifications needed are walking upright and the ability to say words.